Comparative study of bupivacaine-fentanyl versus bupivacaine-clonidine in patients undergoing spinal anaesthesia for lower abdominal surgery

Abstract

Background: There are many adjuvants used along with bupivacaine for subarachnoid block, but Fentanyl and Clonidine are commonly used as adjuvants to intrathecal bupivacaine for prolonging both sensory and motor blockade as well as postoperative analgesia in patients undergoing lowerabdominal surgery.AIM: The present study aimedto compare the effect of intrathecal Clonidine and Fentanyl as adjuvants to Bupivacaine in the subarachnoid block for lower abdominal surgery. Materials and methods: 200 patients belonging to the American Society of Anaesthesiologists I or II,scheduled for lower abdominal surgeryunder spinal anaesthesia were randomly allocated to one of the two following groups to receive Bupivacaine 15mg combined with 50𝜇g clonidine (group A; N =100), Bupivacaine 15mg combined with 25𝜇g., fentanyl (groupB; N=100). Parameters like time for an adequate level of analgesia, peak sensory and motor level reached, duration of sensory, motor block, and incidence of complications was noted in this prospective, randomized double-blinded study. Result: Both the groups were comparable in demographic data, onset and duration of sensory and motor blockade, and hemodynamic parameters, but the duration of analgesia was significantly longer in the Clonidine group when compared with the Fentanyl group,with a mild increase in sedation score. Conclusion: The addition of intrathecal Clonidine in a dose of 50𝜇g provided prolonged postoperative analgesia with minimum side effects compared to Fentanyl and other different doses of Clonidine.